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. 2000 Feb 1;82(5):1017–1021. doi: 10.1054/bjoc.1999.1036

Diagnostic accuracy of large-core needle biopsy for nonpalpable breast disease: a meta-analysis

H M Verkooijen 1, P H M Peeters 3, E Buskens 3, V C M Koot 3, I H M Borel Rinkes 1, W P ThM Mali 2
PMCID: PMC2374424  PMID: 10737383

Abstract

For the evaluation of non-palpable lesions of the breast, image-guided large-core needle biopsies are increasingly replacing needle-localized open breast biopsies. In this study, the diagnostic accuracy of this minimally invasive technique was evaluated by reviewing the available literature. Five cohort studies were included in a meta-analysis. Sensitivity rate, histological agreement between needle biopsy and subsequent surgery or long-term mammographic follow-up and clinical consequences for different disease prevalences were assessed. The sensitivity rate of large-core needle biopsy for the diagnosis of breast cancer was high (97%). The reclassified agreement rate between core biopsy and subsequent surgical biopsy or long-term mammographic follow-up was also high (94%). In case of 20% breast cancer prevalence among women referred after screening (as in the US), the risk of breast cancer despite benign large-core needle biopsy result is less than 1%. In European countries, however, prevalence of breast cancer among referred women is 60–70%. This would result in a risk of breast cancer despite benign large-core needle biopsy result of 4–6%. The results of this meta-analysis indicate that the image guided large-core needle biopsy is a promising alternative for the needle localized breast biopsy. However, additional research is needed to explore the limiting factors of the technique. Without such detailed knowledge, a benign histological diagnosis on large-core needle biopsy in countries with high prevalence of malignancy among referred women should be interpreted with caution. © 2000 Cancer Research Campaign

Keywords: large-core needle biopsy, non-palpable breast disease, diagnostic accuracy, meta-analysis

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Selected References

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